Document Detail


The sensitivity and specificity of high-resolution imaging in evaluating perineural spread of adenoid cystic carcinoma to the skull base.
MedLine Citation:
PMID:  17576903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the sensitivity and specificity of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting perineural spread (PNS) of adenoid cystic carcinoma of the head and neck to the skull base. DESIGN: Adenoid cystic carcinoma of the head and neck frequently exhibits PNS across the skull base. Failure to detect PNS before treatment can have significant negative consequences on the planning and outcome of therapy. High-resolution CT, MRI, or both are used to evaluate the presence of PNS; however, their accuracy in detecting perineural involvement has not yet been determined. PATIENTS: Twenty-six consecutive patients with adenoid cystic carcinoma, who were treated with cranial base resection, were included in this study. The surgical resection specimens of all patients were thoroughly examined by 1 pathologist for the presence of PNS along cranial nerves or their named branches. A total of 38 nerves were examined, and PNS was defined as the presence of tumor in the perineural or endoneural space. The results of the preoperative imaging studies (CT and/or MRI) were then reviewed retrospectively by 1 head and neck radiologist, who was unaware of the pathology report. Radiological evidence of PNS was considered to be present on CT, MRI, or both if nerves showed evidence of thickening (regardless of enhancement), contrast enhancement (regardless of size), or widening of their bony foramina or canals. RESULTS: Histopathologic evidence of PNS was present in 25 (66%) of 38 named nerves. The sensitivity and specificity of CT in detecting PNS were 88% and 89%, respectively. Magnetic resonance imaging had a higher sensitivity (100%) and specificity (85%). CONCLUSIONS: Perineural spread across the skull base is a frequent occurrence in patients with adenoid cystic carcinoma of the head and neck. Magnetic resonance imaging has a higher sensitivity and specificity than CT in detecting PNS along the base of the skull.
Authors:
Ehab Hanna; Emre Vural; Emmanuel Prokopakis; Ricardo Carrau; Carl Snyderman; Jane Weissman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  133     ISSN:  0886-4470     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-19     Completed Date:  2007-07-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  541-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 441, Houston, TX 77030, USA. eyhanna@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Adenoid Cystic / pathology,  radiography*
Contrast Media
Cranial Nerve Neoplasms / pathology
False Negative Reactions
False Positive Reactions
Head and Neck Neoplasms / pathology,  radiography*
Humans
Image Enhancement
Image Processing, Computer-Assisted / methods*,  statistics & numerical data
Magnetic Resonance Imaging / methods*
Neoplasm Invasiveness
Radiographic Image Enhancement
Retrospective Studies
Sensitivity and Specificity
Skull Base Neoplasms / pathology,  radiography*
Tomography, X-Ray Computed / methods*,  statistics & numerical data
Chemical
Reg. No./Substance:
0/Contrast Media

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